弥散张量成像联合血清白细胞介素-1β、磷酸化高分子量神经微丝蛋白诊断脊髓损伤  

Diffusion tensor imaging combined with serum interleukin-1βand phosphorylated high molecular weight neurofilament for diagnosing spinal cord injury

作　　者：朱晓龙[1] 黄婧潇 邹殿俊[1] 马永青 孙日晖 朱月香[1] ZHU Xiaolong;HUANG Jingxiao;ZOU Dianjun;MA Yongqing;SUN Rihui;ZHU Yuexiang(Department of Medical Imaging, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China)

机构地区：[1]河北北方学院附属第一医院医学影像部,河北张家口075000

出　　处：《中国介入影像与治疗学》2022年第7期415-420,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：河北省技术创新引导计划项目(20477702D)。

摘　　要：目的观察弥散张量成像(DTI)联合血清白细胞介素-1β(IL-1β)、磷酸化高分子量神经微丝蛋白(pNF-H)诊断脊髓损伤的价值。方法回顾性分析69例脊髓损伤(C1~T1水平损伤)患者(观察组)和100名健康体检者(对照组)DTI资料,记录其表观弥散系数(ADC)、各向异性分数(FA)值,以及血清IL-1β、pNF-H水平。根据美国脊髓损伤协会(ASIA)残损分级法对观察组脊髓损伤程度进行分级(D/C/B/A级);比较组间及观察组内不同脊髓损伤分级患者DTI参数及血清指标的差异,分析DTI参数及血清指标与脊髓损伤严重程度的相关性。以受试者工作特征(ROC)曲线及曲线下面积(AUC)评估ADC、FA、IL-1β、pNF-H值单独及联合诊断脊髓损伤的效能。结果相比对照组,观察组FA值降低,ADC值及血清IL-1β、pNF-H水平升高(P均=0.001)。随ASIA分级由D级至A级,观察组FA值逐渐降低,ADC值及血清IL-1β、pNF-H水平逐渐升高(P均<0.05);脊髓损伤严重程度与FA值呈负相关(r=-0.489,P<0.001),与ADC值及血清IL-1β、pNF-H水平呈正相关(r=0.542、0.599、0.596,P均<0.001)。FA值、ADC值及血清IL-1β、pNF-H单独诊断脊髓损伤的AUC分别为0.747、0.809、0.794、0.741,联合诊断为0.845(P均=0.01)。结论DTI联合血清IL-1β、pNF-H有助于诊断脊髓损伤。Objective To observe the value of diffusion tensor imaging(DTI)combined with serum interleukin-1β(IL-1β)and phosphorylated high molecular weight neurofilament(pNF-H)for diagnosing spinal cord injury.Methods DTI data of 69 spinal cord(C1-T1 level injury)injury patients(observed group)and 100 healthy subjects(control group)were retrospectively analyzed.Apparent diffusion coefficient(ADC)and fractional anisotropy(FA)values were obtained,and serum IL-1βand pNF-H levels were detected.Patients in observed group were classified according to American Spinal Injury Association(ASIA)impairment classification(grade D/C/B/A).DTI parameters and serum indexes were compared between groups,also among different ASIA grades.The correlation of DTI parameters and serum indexes and the severity of spinal cord injury in observed group were analyzed.Receiver operating characteristic(ROC)curves were drawn,and the area under the curve(AUC)were calculated to evaluate the efficacy of ADC,FA,IL-1βand pNF-H alone and in combination for diagnosing spinal cord injury.Results Compared with control group,FA value of observed group decreased,while ADC value,IL-1βand pNF-H levels increased(all P=0.001).With the classification of ASIA from grade D to grade A,FA value of spinal cord injury decreased gradually,while ADC value,serum IL-1βand PNF-H levels increased gradually(all P<0.05).In observed group,FA value was negatively correlated(r=-0.489,P<0.001)but ADC value,serum IL-1βand pNF-H levels were positively correlated with the severity of spinal cord injury(r=0.542,0.599,0.596,all P<0.001).AUC of FA,ADC,IL-1βand pNF-H alone and combination of all for diagnosing spinal cord injury was 0.747,0.809,0.794,0.741 and 0.845(all P=0.01).Conclusion DTI combined with serum IL-1βand pNF-H was helpful for diagnosing spinal cord injury.

关 键 词：脊髓损伤 磁共振成像 弥散 弥散张量成像 白细胞介素 磷酸化高分子量神经微丝蛋白 滑雪 

分 类 号：R881.5[医药卫生—临床医学] R445.2